| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology and Neurosurgery, McGill University; Montreal Neurological Hospital and Institute (Drs. Tasch, Cendes, Li, Dubeau, Andermann, and Arnold); and The Montreal Children's Hospital (Drs. Montes, Rosenblatt, and Andermann), Canada.
Address correspondence and reprint requests to Dr. Frederick Andermann, Montreal Neurological Hospital, 3801 University, Montreal, Quebec H3A 2B4 Canada.
Background: Patients with hypothalamic hamartomas present with epileptic attacks of laughter and later experience multiple seizure types and cognitive decline, suggestive of secondary generalized epilepsy. It has been suggested in the past that gelastic seizures originate in the temporal lobes rather than in the hamartoma, but temporal resections have been ineffective. Recent electrophysiologic evidence suggests that the epileptogenic discharges may originate in the hamartoma itself.
Methods: We used proton magnetic resonance spectroscopic imaging to quantify the amount of neuronal damage in the temporal lobes and hamartomas of patients with hypothalamic hamartomas and gelastic seizures. Five patients were studied and the relative intensity of N-acetylaspartate to creatine (NAA/Cr) was determined for both temporal lobes as well as for the hamartoma. These values were compared with signals from the temporal lobes and hypothalami of normal control subjects.
Results: NAA/Cr was not significantly different from normal control subjects for either temporal lobe, nor was there a significant asymmetry between the two temporal lobes for any of the patients. NAA resonance signals were present in the hamartomas, and the ratio of NAA to Cr was decreased in the hamartomas compared with the hypothalami of normal control subjects (t = 4.5, p = 0.005).
Conclusions: We found no detectable neuronal damage in the temporal lobes of patients with hypothalamic hamartomas and gelastic epilepsy. This is further evidence that gelastic seizures do not originate in the temporal lobes of these patients.
Presented in part at the 49th annual meeting of the American Academy of Neurology; Boston, MA; March 1997.
Received March 25, 1998. Accepted in final form June 6, 1998.
This article has been cited by other articles:
|
|
 |
|
  D.R. Amstutz, S.W. Coons, J.F. Kerrigan, H.L. Rekate, and J.E. Heiserman Hypothalamic hamartomas: Correlation of MR imaging and spectroscopic findings with tumor glial content. AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 794 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Freeman, L. T. Coleman, R. M. Wellard, M. J. Kean, J. V. Rosenfeld, G. D. Jackson, S. F. Berkovic, and A. S. Harvey MR Imaging and Spectroscopic Study of Epileptogenic Hypothalamic Hamartomas: Analysis of 72 Cases AJNR Am. J. Neuroradiol., March 1, 2004; 25(3): 450 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Wild, F. A. Rodden, W. Grodd, and W. Ruch Neural correlates of laughter and humour Brain, October 1, 2003; 126(10): 2121 - 2138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. D. Martin, U. Seeger, M. B. Ranke, and W. Grodd MR Imaging and Spectroscopy of a Tuber Cinereum Hamartoma in a Patient with Growth Hormone Deficiency and Hypogonadotropic Hypogonadism AJNR Am. J. Neuroradiol., June 1, 2003; 24(6): 1177 - 1180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. I. Akman, R. Schubert, M. Duran, and J. Loh Gelastic Seizure With Tectal Tumor, Lobar Holoprosencephaly, and Subependymal Nodules: Clinical Report J Child Neurol, February 1, 2002; 17(2): 152 - 154. [Abstract] [PDF]
|
|
|
|
 |
|
 N B Wright Imaging in epilepsy: a paediatric perspective Br. J. Radiol., July 1, 2001; 74(883): 575 - 589. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
